{
 "dataset_version": "2026-08-31",
 "license": "CC BY 4.0",
 "attribution": "GLP-1 Price Compare, glp1pricecompare.com",
 "provider": {
  "provider_id": "prv_form_health",
  "canonical_name": "Form Health",
  "slug": "form-health",
  "aliases": [],
  "official_domain": "formhealth.co",
  "legal_entity_name": null,
  "provider_type": "insurance_first",
  "pricing_model": "insurance-first",
  "medications": {
   "semaglutide": false,
   "tirzepatide": false,
   "brand": true,
   "oral": false
  },
  "membership_fee_monthly_usd": null,
  "shipping": "unknown",
  "consultation": "unknown",
  "consultation_fee_usd": null,
  "dose_pricing": "not_stated",
  "price_lock_stated": false,
  "commitment": "not captured",
  "cancellation": "not captured",
  "pharmacy_type": "Not applicable (brand medication via retail pharmacy) or unknown",
  "pharmacies": [],
  "states_served": "unknown",
  "states_excluded": [],
  "insurance_support": true,
  "support_247": null,
  "care_model": "Virtual obesity-medicine clinic: board-certified physicians and registered dietitians, with medication (FDA-approved brands) prescribed through the patient's insurance where covered",
  "consultation_type": "video",
  "affiliate_relationship": false,
  "affiliate_last_verified": null,
  "verification_status": "unverified",
  "last_verified": null,
  "regulatory_records": [],
  "url": "/providers/form-health/"
 },
 "observations": [
  {
   "observation_id": "obs_form-health_tirzepatide_brand-access_pen_1",
   "provider_id": "prv_form_health",
   "provider": "Form Health",
   "slug": "form-health",
   "medication": "tirzepatide",
   "formulation": "brand_access_program",
   "protocol": "brand-access",
   "form": "pen",
   "plan_term_months": 1,
   "term_label": "month-to-month",
   "advertised_monthly_price_usd": null,
   "maintenance_monthly_price_usd": null,
   "introductory_months": 0,
   "first_month_total_usd": null,
   "billing_cycle": "monthly",
   "billing_cycle_days": 30,
   "calendar_month_equivalent_usd": null,
   "upfront_payment_usd": null,
   "mandatory_membership_fee_usd": null,
   "shipping": "unknown",
   "consultation": "unknown",
   "provider_care_included": false,
   "medication_included": false,
   "dose_pricing": "not_stated",
   "maintenance_price_published": true,
   "true_monthly_usd": null,
   "true_monthly_starting_usd": null,
   "annual_total_usd": null,
   "annual_assumptions": [
    "price unknown"
   ],
   "price_source_url": "https://www.formhealth.co",
   "source_type": "provider_page",
   "source_quote": null,
   "verified_at": null,
   "verification_status": "unverified",
   "grade": "U",
   "grade_reason": "No purchasable price is published on the provider's page.",
   "freshness_days": null,
   "freshness": "Unknown",
   "rankable": false,
   "flags": [
    "price unknown"
   ],
   "note": "Program billed through insurance where accepted; cash program pricing and any membership fee were not captured in the sources we hold. Brand medication (Zepbound, Wegovy, Mounjaro, Ozempic) is billed through the pharmacy benefit or at manufacturer cash prices.",
   "third_party_reports": [],
   "latest_change": null
  }
 ],
 "price_history": []
}